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An eight-year multicenter study on short-term peripheral intravenous catheter–related bloodstream infection rates in 100 intensive care units of 9 countries in Latin America: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Venezuela. Findings of the International Nosocomial Infection Control Consortium (INICC)

Published online by Cambridge University Press:  14 January 2021

Victor Daniel Rosenthal*
Affiliation:
International Nosocomial Infection Control Consortium (INICC), City of Buenos Aires, Argentina
Gustavo Jorge Chaparro
Affiliation:
Adult Intensive Care Unit, Instituto Medico Platense SA, Province of Buenos Aires, La Plata, Argentina
Eduardo Alexandrino Servolo-Medeiros
Affiliation:
Hospital Sao Paulo Escola Paulista De Medicina Unifesp, Sao Paulo, Brazil
Dayana Souza-Fram
Affiliation:
Hospital Sao Paulo Escola Paulista De Medicina Unifesp, Sao Paulo, Brazil
Daniela Vieira da Silva Escudero
Affiliation:
Hospital Sao Paulo Escola Paulista De Medicina Unifesp, Sao Paulo, Brazil
Sandra Milena Gualtero-Trujillo
Affiliation:
Pontificia Universidad Javeriana Hospital Universitario San Ignacio, Bogota, Colombia
Rayo Morfin-Otero
Affiliation:
Adult Infectious Diseases, Antiguo hospital Civil de Guadalajara, Guadalajara, México
Esteban Gonzalez-Diaz
Affiliation:
Adult Infectious Diseases, Antiguo hospital Civil de Guadalajara, Guadalajara, México
Eduardo Rodriguez-Noriega
Affiliation:
Adult Infectious Diseases, Antiguo hospital Civil de Guadalajara, Guadalajara, México
Miguel Angel Altuzar-Figueroa
Affiliation:
Hospital General De Zona UMAA No 1 Oaxaca, Demetrio Mayoral Pardo, Oaxaca de Juarez, Mexico
Guadalupe Aguirre-Avalos
Affiliation:
Intensive Care Unit, Hospital Civil de Guadalajara “Fray Antonio Alcalde,”Guadalajara, Jalisco, México
Julio César Mijangos-Méndez
Affiliation:
Intensive Care Unit, Hospital Civil de Guadalajara “Fray Antonio Alcalde,”Guadalajara, Jalisco, México
Federico Corona-Jiménez
Affiliation:
Intensive Care Unit, Hospital Civil de Guadalajara “Fray Antonio Alcalde,”Guadalajara, Jalisco, México
Blanca Estela Hernandez-Chena
Affiliation:
Hospital General Regional Nro 6 IMSS, Madero City, Mexico
Mohamed Rajab Abu-Jarad
Affiliation:
Hospital General Regional Nro 6 IMSS, Madero City, Mexico
Evelia Maria Diaz-Hernandez
Affiliation:
Hospital General Regional Nro 6 IMSS, Madero City, Mexico
María Guadalupe Miranda-Novales
Affiliation:
Hospital De Pediatria Centro Medico Nacional Siglo XXI IMSS, Mexico DF, Mexico
José Guillermo Vázquez-Rosales
Affiliation:
Hospital De Pediatria Centro Medico Nacional Siglo XXI IMSS, Mexico DF, Mexico
Daisy Aguilar-De-Morós
Affiliation:
Hospital del Niño Dr José Renán Esquivel, Panamá
Elizabeth Castaño-Guerra
Affiliation:
Hospital del Niño Dr José Renán Esquivel, Panamá
Gabriel Munoz-Gutierrez
Affiliation:
Hospital Clinica Biblica, San Jose de Costa Rica, Costa Rica
Nepomuceno Mejia
Affiliation:
Hospital General De La Plaza De La Salud, Santo Domingo, Dominican Republic
Jenia Johana Acebo-Arcentales
Affiliation:
Hospital Oncologico Solon Espinoza Ayala, Quito, Ecuador
Gabriela Di-Silvestre
Affiliation:
Hospital De Clinicas Caracas, Caracas, Venezuela
*
Author for correspondence: Victor Daniel Rosenthal, E-mail: victor_rosenthal@inicc.org

Abstract

Background:

Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied.

Methods:

International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used.

Results:

In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040).

The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%.

Conclusions:

Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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